| NPI | 1770569188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A66085) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 9775) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2015-06-18 |